|
PR ANOSCOPY CONTROL BLEEDING
|
Professional
|
Both
|
$626.00
|
|
|
Service Code
|
HCPCS 46614
|
| Min. Negotiated Rate |
$41.11 |
| Max. Negotiated Rate |
$438.20 |
| Rate for Payer: Aetna Commercial |
$84.74
|
| Rate for Payer: Aetna Medicare |
$63.24
|
| Rate for Payer: BCBS Complete |
$43.17
|
| Rate for Payer: BCBS MAPPO |
$63.24
|
| Rate for Payer: BCBS Trust/PPO |
$241.96
|
| Rate for Payer: BCN Commercial |
$249.71
|
| Rate for Payer: BCN Medicare Advantage |
$63.24
|
| Rate for Payer: Cash Price |
$500.80
|
| Rate for Payer: Cash Price |
$500.80
|
| Rate for Payer: Cofinity Commercial |
$84.74
|
| Rate for Payer: Cofinity Commercial |
$91.07
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$63.24
|
| Rate for Payer: Healthscope Commercial |
$75.89
|
| Rate for Payer: Healthscope Whirlpool |
$75.89
|
| Rate for Payer: Meridian Medicaid |
$43.17
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$66.40
|
| Rate for Payer: PACE SWMI |
$63.24
|
| Rate for Payer: PHP Medicare Advantage |
$63.24
|
| Rate for Payer: Priority Health Choice Medicaid |
$41.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$438.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$112.88
|
| Rate for Payer: Priority Health Medicare |
$63.24
|
| Rate for Payer: Priority Health Narrow Network |
$112.88
|
| Rate for Payer: UHC Medicare Advantage |
$65.14
|
|
|
PR ANOSCOPY DX W/COLLJ SPEC BR/WA SPX WHEN PRFRMD
|
Professional
|
Both
|
$181.00
|
|
|
Service Code
|
HCPCS 46600
|
| Min. Negotiated Rate |
$26.41 |
| Max. Negotiated Rate |
$2,291.24 |
| Rate for Payer: Aetna Commercial |
$53.85
|
| Rate for Payer: Aetna Medicare |
$40.19
|
| Rate for Payer: BCBS Complete |
$27.73
|
| Rate for Payer: BCBS MAPPO |
$40.19
|
| Rate for Payer: BCBS Trust/PPO |
$2,291.24
|
| Rate for Payer: BCN Commercial |
$141.36
|
| Rate for Payer: BCN Medicare Advantage |
$40.19
|
| Rate for Payer: Cash Price |
$144.80
|
| Rate for Payer: Cash Price |
$144.80
|
| Rate for Payer: Cofinity Commercial |
$57.87
|
| Rate for Payer: Cofinity Commercial |
$53.85
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$40.19
|
| Rate for Payer: Healthscope Commercial |
$48.23
|
| Rate for Payer: Healthscope Whirlpool |
$48.23
|
| Rate for Payer: Meridian Medicaid |
$27.73
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$42.20
|
| Rate for Payer: PACE SWMI |
$40.19
|
| Rate for Payer: PHP Medicare Advantage |
$40.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$26.41
|
| Rate for Payer: Priority Health Cigna Priority Health |
$126.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$72.32
|
| Rate for Payer: Priority Health Medicare |
$40.19
|
| Rate for Payer: Priority Health Narrow Network |
$72.32
|
| Rate for Payer: UHC Medicare Advantage |
$41.40
|
|
|
PR ANOSCOPY DX W/HRA &CHEM AGNTS ENHANCEMENT
|
Professional
|
Both
|
$267.00
|
|
|
Service Code
|
HCPCS 46601
|
| Min. Negotiated Rate |
$59.64 |
| Max. Negotiated Rate |
$375.62 |
| Rate for Payer: Aetna Commercial |
$122.29
|
| Rate for Payer: Aetna Medicare |
$91.26
|
| Rate for Payer: BCBS Complete |
$62.62
|
| Rate for Payer: BCBS MAPPO |
$91.26
|
| Rate for Payer: BCBS Trust/PPO |
$375.62
|
| Rate for Payer: BCN Commercial |
$218.93
|
| Rate for Payer: BCN Medicare Advantage |
$91.26
|
| Rate for Payer: Cash Price |
$213.60
|
| Rate for Payer: Cash Price |
$213.60
|
| Rate for Payer: Cofinity Commercial |
$122.29
|
| Rate for Payer: Cofinity Commercial |
$131.41
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$91.26
|
| Rate for Payer: Healthscope Commercial |
$109.51
|
| Rate for Payer: Healthscope Whirlpool |
$109.51
|
| Rate for Payer: Meridian Medicaid |
$62.62
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$95.82
|
| Rate for Payer: PACE SWMI |
$91.26
|
| Rate for Payer: PHP Medicare Advantage |
$91.26
|
| Rate for Payer: Priority Health Choice Medicaid |
$59.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$186.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$162.28
|
| Rate for Payer: Priority Health Medicare |
$91.26
|
| Rate for Payer: Priority Health Narrow Network |
$162.28
|
| Rate for Payer: UHC Medicare Advantage |
$94.00
|
|
|
PR ANOSCOPY DX W/HRA &CHEM AGNTS ENHANCEMENT W/BX
|
Professional
|
Both
|
$282.00
|
|
|
Service Code
|
HCPCS 46607
|
| Min. Negotiated Rate |
$79.24 |
| Max. Negotiated Rate |
$1,451.24 |
| Rate for Payer: Aetna Commercial |
$163.37
|
| Rate for Payer: Aetna Medicare |
$121.92
|
| Rate for Payer: BCBS Complete |
$83.20
|
| Rate for Payer: BCBS MAPPO |
$121.92
|
| Rate for Payer: BCBS Trust/PPO |
$1,451.24
|
| Rate for Payer: BCN Commercial |
$302.98
|
| Rate for Payer: BCN Medicare Advantage |
$121.92
|
| Rate for Payer: Cash Price |
$225.60
|
| Rate for Payer: Cash Price |
$225.60
|
| Rate for Payer: Cofinity Commercial |
$175.56
|
| Rate for Payer: Cofinity Commercial |
$163.37
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$121.92
|
| Rate for Payer: Healthscope Commercial |
$146.30
|
| Rate for Payer: Healthscope Whirlpool |
$146.30
|
| Rate for Payer: Meridian Medicaid |
$83.20
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$128.02
|
| Rate for Payer: PACE SWMI |
$121.92
|
| Rate for Payer: PHP Medicare Advantage |
$121.92
|
| Rate for Payer: Priority Health Choice Medicaid |
$79.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$197.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$216.37
|
| Rate for Payer: Priority Health Medicare |
$121.92
|
| Rate for Payer: Priority Health Narrow Network |
$216.37
|
| Rate for Payer: UHC Medicare Advantage |
$125.58
|
|
|
PR ANOSCOPY W/BX SINGLE/MULTIPLE
|
Professional
|
Both
|
$360.00
|
|
|
Service Code
|
HCPCS 46606
|
| Min. Negotiated Rate |
$48.14 |
| Max. Negotiated Rate |
$3,172.97 |
| Rate for Payer: Aetna Commercial |
$98.60
|
| Rate for Payer: Aetna Medicare |
$73.58
|
| Rate for Payer: BCBS Complete |
$50.55
|
| Rate for Payer: BCBS MAPPO |
$73.58
|
| Rate for Payer: BCBS Trust/PPO |
$3,172.97
|
| Rate for Payer: BCN Commercial |
$414.40
|
| Rate for Payer: BCN Medicare Advantage |
$73.58
|
| Rate for Payer: Cash Price |
$288.00
|
| Rate for Payer: Cash Price |
$288.00
|
| Rate for Payer: Cofinity Commercial |
$105.96
|
| Rate for Payer: Cofinity Commercial |
$98.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$73.58
|
| Rate for Payer: Healthscope Commercial |
$88.30
|
| Rate for Payer: Healthscope Whirlpool |
$88.30
|
| Rate for Payer: Meridian Medicaid |
$50.55
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$77.26
|
| Rate for Payer: PACE SWMI |
$73.58
|
| Rate for Payer: PHP Medicare Advantage |
$73.58
|
| Rate for Payer: Priority Health Choice Medicaid |
$48.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$252.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$131.12
|
| Rate for Payer: Priority Health Medicare |
$73.58
|
| Rate for Payer: Priority Health Narrow Network |
$131.12
|
| Rate for Payer: UHC Medicare Advantage |
$75.79
|
|
|
PR ANOSCOPY W/DILATION
|
Professional
|
Both
|
$986.00
|
|
|
Service Code
|
HCPCS 46604
|
| Min. Negotiated Rate |
$42.17 |
| Max. Negotiated Rate |
$2,787.84 |
| Rate for Payer: Aetna Commercial |
$86.59
|
| Rate for Payer: Aetna Medicare |
$64.62
|
| Rate for Payer: BCBS Complete |
$44.28
|
| Rate for Payer: BCBS MAPPO |
$64.62
|
| Rate for Payer: BCBS Trust/PPO |
$2,787.84
|
| Rate for Payer: BCN Commercial |
$967.58
|
| Rate for Payer: BCN Medicare Advantage |
$64.62
|
| Rate for Payer: Cash Price |
$788.80
|
| Rate for Payer: Cash Price |
$788.80
|
| Rate for Payer: Cofinity Commercial |
$93.05
|
| Rate for Payer: Cofinity Commercial |
$86.59
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$64.62
|
| Rate for Payer: Healthscope Commercial |
$77.54
|
| Rate for Payer: Healthscope Whirlpool |
$77.54
|
| Rate for Payer: Meridian Medicaid |
$44.28
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$67.85
|
| Rate for Payer: PACE SWMI |
$64.62
|
| Rate for Payer: PHP Medicare Advantage |
$64.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$42.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$690.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$115.24
|
| Rate for Payer: Priority Health Medicare |
$64.62
|
| Rate for Payer: Priority Health Narrow Network |
$115.24
|
| Rate for Payer: UHC Medicare Advantage |
$66.56
|
|
|
PR ANOSCOPY W/RMVL FOREIGN BODY
|
Professional
|
Both
|
$349.00
|
|
|
Service Code
|
HCPCS 46608
|
| Min. Negotiated Rate |
$54.10 |
| Max. Negotiated Rate |
$432.96 |
| Rate for Payer: Aetna Commercial |
$112.05
|
| Rate for Payer: Aetna Medicare |
$83.62
|
| Rate for Payer: BCBS Complete |
$56.80
|
| Rate for Payer: BCBS MAPPO |
$83.62
|
| Rate for Payer: BCBS Trust/PPO |
$241.96
|
| Rate for Payer: BCN Commercial |
$432.96
|
| Rate for Payer: BCN Medicare Advantage |
$83.62
|
| Rate for Payer: Cash Price |
$279.20
|
| Rate for Payer: Cash Price |
$279.20
|
| Rate for Payer: Cofinity Commercial |
$120.41
|
| Rate for Payer: Cofinity Commercial |
$112.05
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$83.62
|
| Rate for Payer: Healthscope Commercial |
$100.34
|
| Rate for Payer: Healthscope Whirlpool |
$100.34
|
| Rate for Payer: Meridian Medicaid |
$56.80
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$87.80
|
| Rate for Payer: PACE SWMI |
$83.62
|
| Rate for Payer: PHP Medicare Advantage |
$83.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$54.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$244.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$148.18
|
| Rate for Payer: Priority Health Medicare |
$83.62
|
| Rate for Payer: Priority Health Narrow Network |
$148.18
|
| Rate for Payer: UHC Medicare Advantage |
$86.13
|
|
|
PR ANOSCOPY W/RMVL LESION CAUTERY
|
Professional
|
Both
|
$563.00
|
|
|
Service Code
|
HCPCS 46610
|
| Min. Negotiated Rate |
$51.12 |
| Max. Negotiated Rate |
$410.00 |
| Rate for Payer: Aetna Commercial |
$105.91
|
| Rate for Payer: Aetna Medicare |
$79.04
|
| Rate for Payer: BCBS Complete |
$53.68
|
| Rate for Payer: BCBS MAPPO |
$79.04
|
| Rate for Payer: BCBS Trust/PPO |
$241.96
|
| Rate for Payer: BCN Commercial |
$410.00
|
| Rate for Payer: BCN Medicare Advantage |
$79.04
|
| Rate for Payer: Cash Price |
$450.40
|
| Rate for Payer: Cash Price |
$450.40
|
| Rate for Payer: Cofinity Commercial |
$105.91
|
| Rate for Payer: Cofinity Commercial |
$113.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$79.04
|
| Rate for Payer: Healthscope Commercial |
$94.85
|
| Rate for Payer: Healthscope Whirlpool |
$94.85
|
| Rate for Payer: Meridian Medicaid |
$53.68
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$82.99
|
| Rate for Payer: PACE SWMI |
$79.04
|
| Rate for Payer: PHP Medicare Advantage |
$79.04
|
| Rate for Payer: Priority Health Choice Medicaid |
$51.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$394.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$140.52
|
| Rate for Payer: Priority Health Medicare |
$79.04
|
| Rate for Payer: Priority Health Narrow Network |
$140.52
|
| Rate for Payer: UHC Medicare Advantage |
$81.41
|
|
|
PR ANOSC RMVL 1 TUM POLYP/OTH LES SNARE TQ
|
Professional
|
Both
|
$563.00
|
|
|
Service Code
|
HCPCS 46611
|
| Min. Negotiated Rate |
$51.33 |
| Max. Negotiated Rate |
$2,682.71 |
| Rate for Payer: Aetna Commercial |
$105.14
|
| Rate for Payer: Aetna Medicare |
$78.46
|
| Rate for Payer: BCBS Complete |
$53.90
|
| Rate for Payer: BCBS MAPPO |
$78.46
|
| Rate for Payer: BCBS Trust/PPO |
$2,682.71
|
| Rate for Payer: BCN Commercial |
$329.36
|
| Rate for Payer: BCN Medicare Advantage |
$78.46
|
| Rate for Payer: Cash Price |
$450.40
|
| Rate for Payer: Cash Price |
$450.40
|
| Rate for Payer: Cofinity Commercial |
$105.14
|
| Rate for Payer: Cofinity Commercial |
$112.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$78.46
|
| Rate for Payer: Healthscope Commercial |
$94.15
|
| Rate for Payer: Healthscope Whirlpool |
$94.15
|
| Rate for Payer: Meridian Medicaid |
$53.90
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$82.38
|
| Rate for Payer: PACE SWMI |
$78.46
|
| Rate for Payer: PHP Medicare Advantage |
$78.46
|
| Rate for Payer: Priority Health Choice Medicaid |
$51.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$394.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$139.93
|
| Rate for Payer: Priority Health Medicare |
$78.46
|
| Rate for Payer: Priority Health Narrow Network |
$139.93
|
| Rate for Payer: UHC Medicare Advantage |
$80.81
|
|
|
PR ANOSC RMVL MULT TUMORS CAUTERY/SNARE
|
Professional
|
Both
|
$657.00
|
|
|
Service Code
|
HCPCS 46612
|
| Min. Negotiated Rate |
$60.92 |
| Max. Negotiated Rate |
$494.54 |
| Rate for Payer: Aetna Commercial |
$125.49
|
| Rate for Payer: Aetna Medicare |
$93.65
|
| Rate for Payer: BCBS Complete |
$63.97
|
| Rate for Payer: BCBS MAPPO |
$93.65
|
| Rate for Payer: BCBS Trust/PPO |
$316.98
|
| Rate for Payer: BCN Commercial |
$494.54
|
| Rate for Payer: BCN Medicare Advantage |
$93.65
|
| Rate for Payer: Cash Price |
$525.60
|
| Rate for Payer: Cash Price |
$525.60
|
| Rate for Payer: Cofinity Commercial |
$134.86
|
| Rate for Payer: Cofinity Commercial |
$125.49
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$93.65
|
| Rate for Payer: Healthscope Commercial |
$112.38
|
| Rate for Payer: Healthscope Whirlpool |
$112.38
|
| Rate for Payer: Meridian Medicaid |
$63.97
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$98.33
|
| Rate for Payer: PACE SWMI |
$93.65
|
| Rate for Payer: PHP Medicare Advantage |
$93.65
|
| Rate for Payer: Priority Health Choice Medicaid |
$60.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$459.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$165.81
|
| Rate for Payer: Priority Health Medicare |
$93.65
|
| Rate for Payer: Priority Health Narrow Network |
$165.81
|
| Rate for Payer: UHC Medicare Advantage |
$96.46
|
|
|
PR ANRCT XM SURG REQ ANES GENERAL SPI/EDRL DX
|
Professional
|
Both
|
$316.00
|
|
|
Service Code
|
HCPCS 45990
|
| Hospital Charge Code |
45990
|
| Min. Negotiated Rate |
$67.31 |
| Max. Negotiated Rate |
$1,244.67 |
| Rate for Payer: Aetna Commercial |
$138.18
|
| Rate for Payer: Aetna Medicare |
$103.12
|
| Rate for Payer: BCBS Complete |
$70.68
|
| Rate for Payer: BCBS MAPPO |
$103.12
|
| Rate for Payer: BCBS Trust/PPO |
$1,244.67
|
| Rate for Payer: BCN Commercial |
$151.98
|
| Rate for Payer: BCN Medicare Advantage |
$103.12
|
| Rate for Payer: Cash Price |
$252.80
|
| Rate for Payer: Cash Price |
$252.80
|
| Rate for Payer: Cofinity Commercial |
$148.49
|
| Rate for Payer: Cofinity Commercial |
$138.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$103.12
|
| Rate for Payer: Healthscope Commercial |
$123.74
|
| Rate for Payer: Healthscope Whirlpool |
$123.74
|
| Rate for Payer: Meridian Medicaid |
$70.68
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$108.28
|
| Rate for Payer: PACE SWMI |
$103.12
|
| Rate for Payer: PHP Medicare Advantage |
$103.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$67.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$221.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$182.86
|
| Rate for Payer: Priority Health Medicare |
$103.12
|
| Rate for Payer: Priority Health Narrow Network |
$182.86
|
| Rate for Payer: UHC Medicare Advantage |
$106.21
|
|
|
PR ANRCT XM SURG REQ ANES GENERAL SPI/EDRL DX
|
Professional
|
Both
|
$316.00
|
|
|
Service Code
|
HCPCS 45990
|
| Min. Negotiated Rate |
$67.31 |
| Max. Negotiated Rate |
$1,244.67 |
| Rate for Payer: Aetna Commercial |
$138.18
|
| Rate for Payer: Aetna Medicare |
$103.12
|
| Rate for Payer: BCBS Complete |
$70.68
|
| Rate for Payer: BCBS MAPPO |
$103.12
|
| Rate for Payer: BCBS Trust/PPO |
$1,244.67
|
| Rate for Payer: BCN Commercial |
$151.98
|
| Rate for Payer: BCN Medicare Advantage |
$103.12
|
| Rate for Payer: Cash Price |
$252.80
|
| Rate for Payer: Cash Price |
$252.80
|
| Rate for Payer: Cofinity Commercial |
$148.49
|
| Rate for Payer: Cofinity Commercial |
$138.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$103.12
|
| Rate for Payer: Healthscope Commercial |
$123.74
|
| Rate for Payer: Healthscope Whirlpool |
$123.74
|
| Rate for Payer: Meridian Medicaid |
$70.68
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$108.28
|
| Rate for Payer: PACE SWMI |
$103.12
|
| Rate for Payer: PHP Medicare Advantage |
$103.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$67.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$221.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$182.86
|
| Rate for Payer: Priority Health Medicare |
$103.12
|
| Rate for Payer: Priority Health Narrow Network |
$182.86
|
| Rate for Payer: UHC Medicare Advantage |
$106.21
|
|
|
PR ANRCT XM SURG REQ ANES GENERAL SPI/EDRL DX
|
Facility
|
OP
|
$316.00
|
|
|
Service Code
|
CPT 45990
|
| Hospital Charge Code |
45990
|
| Min. Negotiated Rate |
$221.20 |
| Max. Negotiated Rate |
$3,119.72 |
| Rate for Payer: Aetna Commercial |
$284.40
|
| Rate for Payer: Aetna Medicare |
$2,495.78
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,119.72
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,119.72
|
| Rate for Payer: ASR ASR |
$306.52
|
| Rate for Payer: BCBS Complete |
$1,433.58
|
| Rate for Payer: BCBS MAPPO |
$2,495.78
|
| Rate for Payer: BCBS Trust/PPO |
$244.99
|
| Rate for Payer: BCN Commercial |
$244.99
|
| Rate for Payer: BCN Medicare Advantage |
$2,495.78
|
| Rate for Payer: Cash Price |
$252.80
|
| Rate for Payer: Cash Price |
$252.80
|
| Rate for Payer: Cofinity Commercial |
$297.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$252.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,495.78
|
| Rate for Payer: Healthscope Commercial |
$316.00
|
| Rate for Payer: Healthscope Whirlpool |
$306.52
|
| Rate for Payer: Humana Choice PPO Medicare |
$2,495.78
|
| Rate for Payer: Mclaren Commercial |
$284.40
|
| Rate for Payer: Mclaren Medicaid |
$1,365.19
|
| Rate for Payer: Mclaren Medicare |
$2,495.78
|
| Rate for Payer: Meridian Medicaid |
$1,433.58
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$2,620.57
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,870.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$268.60
|
| Rate for Payer: PACE Medicare |
$2,370.99
|
| Rate for Payer: PACE SWMI |
$2,495.78
|
| Rate for Payer: PHP Commercial |
$2,745.36
|
| Rate for Payer: PHP Medicaid |
$1,365.19
|
| Rate for Payer: PHP Medicare Advantage |
$2,495.78
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,365.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$221.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$287.56
|
| Rate for Payer: Priority Health Medicare |
$2,495.78
|
| Rate for Payer: Priority Health Narrow Network |
$224.36
|
| Rate for Payer: Railroad Medicare Medicare |
$2,495.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$278.08
|
| Rate for Payer: UHC Medicare Advantage |
$2,570.65
|
| Rate for Payer: VA VA |
$2,495.78
|
|
|
PR ANRCT XM SURG REQ ANES GENERAL SPI/EDRL DX
|
Facility
|
IP
|
$316.00
|
|
|
Service Code
|
CPT 45990
|
| Hospital Charge Code |
45990
|
| Min. Negotiated Rate |
$221.20 |
| Max. Negotiated Rate |
$316.00 |
| Rate for Payer: Aetna Commercial |
$284.40
|
| Rate for Payer: ASR ASR |
$306.52
|
| Rate for Payer: BCBS Trust/PPO |
$244.99
|
| Rate for Payer: BCN Commercial |
$244.99
|
| Rate for Payer: Cash Price |
$252.80
|
| Rate for Payer: Cofinity Commercial |
$297.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$252.80
|
| Rate for Payer: Healthscope Commercial |
$316.00
|
| Rate for Payer: Healthscope Whirlpool |
$306.52
|
| Rate for Payer: Mclaren Commercial |
$284.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$268.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$221.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$278.08
|
|
|
PR ANTEPARTUM CARE ONLY 4-6 VISITS
|
Professional
|
Both
|
$1,133.00
|
|
|
Service Code
|
HCPCS 59425
|
| Min. Negotiated Rate |
$94.57 |
| Max. Negotiated Rate |
$973.77 |
| Rate for Payer: Aetna Commercial |
$584.21
|
| Rate for Payer: Aetna Medicare |
$435.98
|
| Rate for Payer: BCBS Complete |
$422.12
|
| Rate for Payer: BCBS MAPPO |
$435.98
|
| Rate for Payer: BCBS Trust/PPO |
$94.57
|
| Rate for Payer: BCN Commercial |
$973.77
|
| Rate for Payer: BCN Medicare Advantage |
$435.98
|
| Rate for Payer: Cash Price |
$906.40
|
| Rate for Payer: Cash Price |
$906.40
|
| Rate for Payer: Cofinity Commercial |
$627.81
|
| Rate for Payer: Cofinity Commercial |
$584.21
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$435.98
|
| Rate for Payer: Healthscope Commercial |
$523.18
|
| Rate for Payer: Healthscope Whirlpool |
$523.18
|
| Rate for Payer: Meridian Medicaid |
$422.12
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$457.78
|
| Rate for Payer: PACE SWMI |
$435.98
|
| Rate for Payer: PHP Medicare Advantage |
$435.98
|
| Rate for Payer: Priority Health Choice Medicaid |
$402.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$793.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$612.89
|
| Rate for Payer: Priority Health Medicare |
$435.98
|
| Rate for Payer: Priority Health Narrow Network |
$612.89
|
| Rate for Payer: UHC Medicare Advantage |
$449.06
|
|
|
PR ANTEPARTUM CARE ONLY 7/> VISITS
|
Professional
|
Both
|
$1,558.00
|
|
|
Service Code
|
HCPCS 59426
|
| Min. Negotiated Rate |
$55.47 |
| Max. Negotiated Rate |
$1,391.08 |
| Rate for Payer: Aetna Commercial |
$1,072.99
|
| Rate for Payer: Aetna Medicare |
$800.74
|
| Rate for Payer: BCBS Complete |
$775.40
|
| Rate for Payer: BCBS MAPPO |
$800.74
|
| Rate for Payer: BCBS Trust/PPO |
$55.47
|
| Rate for Payer: BCN Commercial |
$1,391.08
|
| Rate for Payer: BCN Medicare Advantage |
$800.74
|
| Rate for Payer: Cash Price |
$1,246.40
|
| Rate for Payer: Cash Price |
$1,246.40
|
| Rate for Payer: Cofinity Commercial |
$1,072.99
|
| Rate for Payer: Cofinity Commercial |
$1,153.07
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$800.74
|
| Rate for Payer: Healthscope Commercial |
$960.89
|
| Rate for Payer: Healthscope Whirlpool |
$960.89
|
| Rate for Payer: Meridian Medicaid |
$775.40
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$840.78
|
| Rate for Payer: PACE SWMI |
$800.74
|
| Rate for Payer: PHP Medicare Advantage |
$800.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$738.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,090.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,125.66
|
| Rate for Payer: Priority Health Medicare |
$800.74
|
| Rate for Payer: Priority Health Narrow Network |
$1,125.66
|
| Rate for Payer: UHC Medicare Advantage |
$824.76
|
|
|
PR ANTERIOR COLPORRAPHY RPR CYSTOCELE W/CYSTO
|
Professional
|
Both
|
$1,523.00
|
|
|
Service Code
|
HCPCS 57240
|
| Min. Negotiated Rate |
$394.26 |
| Max. Negotiated Rate |
$2,162.33 |
| Rate for Payer: Aetna Commercial |
$813.85
|
| Rate for Payer: Aetna Medicare |
$607.35
|
| Rate for Payer: BCBS Complete |
$413.97
|
| Rate for Payer: BCBS MAPPO |
$607.35
|
| Rate for Payer: BCBS Trust/PPO |
$2,162.33
|
| Rate for Payer: BCN Commercial |
$899.66
|
| Rate for Payer: BCN Medicare Advantage |
$607.35
|
| Rate for Payer: Cash Price |
$1,218.40
|
| Rate for Payer: Cash Price |
$1,218.40
|
| Rate for Payer: Cofinity Commercial |
$874.58
|
| Rate for Payer: Cofinity Commercial |
$813.85
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$607.35
|
| Rate for Payer: Healthscope Commercial |
$728.82
|
| Rate for Payer: Healthscope Whirlpool |
$728.82
|
| Rate for Payer: Meridian Medicaid |
$413.97
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$637.72
|
| Rate for Payer: PACE SWMI |
$607.35
|
| Rate for Payer: PHP Medicare Advantage |
$607.35
|
| Rate for Payer: Priority Health Choice Medicaid |
$394.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,066.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$871.57
|
| Rate for Payer: Priority Health Medicare |
$607.35
|
| Rate for Payer: Priority Health Narrow Network |
$871.57
|
| Rate for Payer: UHC Medicare Advantage |
$625.57
|
|
|
PR ANTERIOR INSTRUMENTATION 2-3 VERTEBRAL SEGMENTS
|
Professional
|
Both
|
$3,805.00
|
|
|
Service Code
|
HCPCS 22845
|
| Min. Negotiated Rate |
$92.54 |
| Max. Negotiated Rate |
$2,663.50 |
| Rate for Payer: Aetna Commercial |
$971.77
|
| Rate for Payer: Aetna Medicare |
$725.20
|
| Rate for Payer: BCBS Complete |
$485.77
|
| Rate for Payer: BCBS MAPPO |
$725.20
|
| Rate for Payer: BCBS Trust/PPO |
$92.54
|
| Rate for Payer: BCN Commercial |
$1,164.39
|
| Rate for Payer: BCN Medicare Advantage |
$725.20
|
| Rate for Payer: Cash Price |
$3,044.00
|
| Rate for Payer: Cash Price |
$3,044.00
|
| Rate for Payer: Cofinity Commercial |
$1,044.29
|
| Rate for Payer: Cofinity Commercial |
$971.77
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$725.20
|
| Rate for Payer: Healthscope Commercial |
$870.24
|
| Rate for Payer: Healthscope Whirlpool |
$870.24
|
| Rate for Payer: Meridian Medicaid |
$485.77
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$761.46
|
| Rate for Payer: PACE SWMI |
$725.20
|
| Rate for Payer: PHP Medicare Advantage |
$725.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$462.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,663.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,105.05
|
| Rate for Payer: Priority Health Medicare |
$725.20
|
| Rate for Payer: Priority Health Narrow Network |
$1,105.05
|
| Rate for Payer: UHC Medicare Advantage |
$746.96
|
|
|
PR ANTERIOR INSTRUMENTATION 4-7 VERTEBRAL SEGMENTS
|
Professional
|
Both
|
$4,186.00
|
|
|
Service Code
|
HCPCS 22846
|
| Min. Negotiated Rate |
$62.83 |
| Max. Negotiated Rate |
$2,930.20 |
| Rate for Payer: Aetna Commercial |
$1,011.38
|
| Rate for Payer: Aetna Medicare |
$754.76
|
| Rate for Payer: BCBS Complete |
$505.67
|
| Rate for Payer: BCBS MAPPO |
$754.76
|
| Rate for Payer: BCBS Trust/PPO |
$62.83
|
| Rate for Payer: BCN Commercial |
$1,211.74
|
| Rate for Payer: BCN Medicare Advantage |
$754.76
|
| Rate for Payer: Cash Price |
$3,348.80
|
| Rate for Payer: Cash Price |
$3,348.80
|
| Rate for Payer: Cofinity Commercial |
$1,086.85
|
| Rate for Payer: Cofinity Commercial |
$1,011.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$754.76
|
| Rate for Payer: Healthscope Commercial |
$905.71
|
| Rate for Payer: Healthscope Whirlpool |
$905.71
|
| Rate for Payer: Meridian Medicaid |
$505.67
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$792.50
|
| Rate for Payer: PACE SWMI |
$754.76
|
| Rate for Payer: PHP Medicare Advantage |
$754.76
|
| Rate for Payer: Priority Health Choice Medicaid |
$481.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,930.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,149.98
|
| Rate for Payer: Priority Health Medicare |
$754.76
|
| Rate for Payer: Priority Health Narrow Network |
$1,149.98
|
| Rate for Payer: UHC Medicare Advantage |
$777.40
|
|
|
PR ANTERIOR INSTRUMENTATION 8/> VERTEBRAL SEGMENTS
|
Professional
|
Both
|
$3,705.00
|
|
|
Service Code
|
HCPCS 22847
|
| Min. Negotiated Rate |
$111.22 |
| Max. Negotiated Rate |
$2,593.50 |
| Rate for Payer: Aetna Commercial |
$1,056.86
|
| Rate for Payer: Aetna Medicare |
$788.70
|
| Rate for Payer: BCBS Complete |
$530.72
|
| Rate for Payer: BCBS MAPPO |
$788.70
|
| Rate for Payer: BCBS Trust/PPO |
$111.22
|
| Rate for Payer: BCN Commercial |
$1,158.16
|
| Rate for Payer: BCN Medicare Advantage |
$788.70
|
| Rate for Payer: Cash Price |
$2,964.00
|
| Rate for Payer: Cash Price |
$2,964.00
|
| Rate for Payer: Cofinity Commercial |
$1,056.86
|
| Rate for Payer: Cofinity Commercial |
$1,135.73
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$788.70
|
| Rate for Payer: Healthscope Commercial |
$946.44
|
| Rate for Payer: Healthscope Whirlpool |
$946.44
|
| Rate for Payer: Meridian Medicaid |
$530.72
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$828.14
|
| Rate for Payer: PACE SWMI |
$788.70
|
| Rate for Payer: PHP Medicare Advantage |
$788.70
|
| Rate for Payer: Priority Health Choice Medicaid |
$505.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,593.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,210.25
|
| Rate for Payer: Priority Health Medicare |
$788.70
|
| Rate for Payer: Priority Health Narrow Network |
$1,210.25
|
| Rate for Payer: UHC Medicare Advantage |
$812.36
|
|
|
PR ANTERIOR TIBIAL TUBERCLEPLASTY
|
Professional
|
Both
|
$2,526.00
|
|
|
Service Code
|
HCPCS 27418
|
| Min. Negotiated Rate |
$531.01 |
| Max. Negotiated Rate |
$1,768.20 |
| Rate for Payer: Aetna Commercial |
$1,096.68
|
| Rate for Payer: Aetna Medicare |
$818.42
|
| Rate for Payer: BCBS Complete |
$557.56
|
| Rate for Payer: BCBS MAPPO |
$818.42
|
| Rate for Payer: BCBS Trust/PPO |
$1,136.90
|
| Rate for Payer: BCN Commercial |
$1,343.56
|
| Rate for Payer: BCN Medicare Advantage |
$818.42
|
| Rate for Payer: Cash Price |
$2,020.80
|
| Rate for Payer: Cash Price |
$2,020.80
|
| Rate for Payer: Cofinity Commercial |
$1,178.52
|
| Rate for Payer: Cofinity Commercial |
$1,096.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$818.42
|
| Rate for Payer: Healthscope Commercial |
$982.10
|
| Rate for Payer: Healthscope Whirlpool |
$982.10
|
| Rate for Payer: Meridian Medicaid |
$557.56
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$859.34
|
| Rate for Payer: PACE SWMI |
$818.42
|
| Rate for Payer: PHP Medicare Advantage |
$818.42
|
| Rate for Payer: Priority Health Choice Medicaid |
$531.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,768.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,275.09
|
| Rate for Payer: Priority Health Medicare |
$818.42
|
| Rate for Payer: Priority Health Narrow Network |
$1,275.09
|
| Rate for Payer: UHC Medicare Advantage |
$842.97
|
|
|
PR ANTICOAG MGMT, EACH SUBSEQ 90 DAYS
|
Professional
|
Both
|
$92.00
|
|
|
Service Code
|
HCPCS 99364
|
| Min. Negotiated Rate |
$36.80 |
| Max. Negotiated Rate |
$64.40 |
| Rate for Payer: BCBS Complete |
$36.80
|
| Rate for Payer: Cash Price |
$73.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$64.40
|
|
|
PR ANTICOAG MGMT, INITIAL 90 DAYS
|
Professional
|
Both
|
$203.00
|
|
|
Service Code
|
HCPCS 99363
|
| Min. Negotiated Rate |
$81.20 |
| Max. Negotiated Rate |
$142.10 |
| Rate for Payer: BCBS Complete |
$81.20
|
| Rate for Payer: Cash Price |
$162.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$142.10
|
|
|
PR ANTICOAGULANT MGMT FOR PT TAKING WARFARIN
|
Professional
|
Both
|
$24.00
|
|
|
Service Code
|
HCPCS 93793
|
| Min. Negotiated Rate |
$9.60 |
| Max. Negotiated Rate |
$39.09 |
| Rate for Payer: Aetna Commercial |
$14.87
|
| Rate for Payer: Aetna Medicare |
$11.10
|
| Rate for Payer: BCBS Complete |
$9.60
|
| Rate for Payer: BCBS MAPPO |
$11.10
|
| Rate for Payer: BCBS Trust/PPO |
$39.09
|
| Rate for Payer: BCN Commercial |
$16.61
|
| Rate for Payer: BCN Medicare Advantage |
$11.10
|
| Rate for Payer: Cash Price |
$19.20
|
| Rate for Payer: Cash Price |
$19.20
|
| Rate for Payer: Cofinity Commercial |
$14.87
|
| Rate for Payer: Cofinity Commercial |
$15.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11.10
|
| Rate for Payer: Healthscope Commercial |
$13.32
|
| Rate for Payer: Healthscope Whirlpool |
$13.32
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$11.66
|
| Rate for Payer: PACE SWMI |
$11.10
|
| Rate for Payer: PHP Medicare Advantage |
$11.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$16.08
|
| Rate for Payer: Priority Health Medicare |
$11.10
|
| Rate for Payer: Priority Health Narrow Network |
$16.08
|
| Rate for Payer: UHC Medicare Advantage |
$11.43
|
|
|
PR ANT VESICOURETHROPEXY/URETHROPEXY SMPL
|
Professional
|
Both
|
$2,411.00
|
|
|
Service Code
|
HCPCS 51840
|
| Min. Negotiated Rate |
$444.53 |
| Max. Negotiated Rate |
$5,391.30 |
| Rate for Payer: Aetna Commercial |
$912.63
|
| Rate for Payer: Aetna Medicare |
$681.07
|
| Rate for Payer: BCBS Complete |
$466.76
|
| Rate for Payer: BCBS MAPPO |
$681.07
|
| Rate for Payer: BCBS Trust/PPO |
$5,391.30
|
| Rate for Payer: BCN Commercial |
$1,010.58
|
| Rate for Payer: BCN Medicare Advantage |
$681.07
|
| Rate for Payer: Cash Price |
$1,928.80
|
| Rate for Payer: Cash Price |
$1,928.80
|
| Rate for Payer: Cofinity Commercial |
$980.74
|
| Rate for Payer: Cofinity Commercial |
$912.63
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$681.07
|
| Rate for Payer: Healthscope Commercial |
$817.28
|
| Rate for Payer: Healthscope Whirlpool |
$817.28
|
| Rate for Payer: Meridian Medicaid |
$466.76
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$715.12
|
| Rate for Payer: PACE SWMI |
$681.07
|
| Rate for Payer: PHP Medicare Advantage |
$681.07
|
| Rate for Payer: Priority Health Choice Medicaid |
$444.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,687.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,117.46
|
| Rate for Payer: Priority Health Medicare |
$681.07
|
| Rate for Payer: Priority Health Narrow Network |
$1,117.46
|
| Rate for Payer: UHC Medicare Advantage |
$701.50
|
|
